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1. Surgical management of gastric adenocarcinoma. Official expert recommendations delivered under the aegis of the French Association of Surgery (AFC)

Author

T. Voron, B. Romain, D. Bergeat, J. Véziant, J. Gagnière, B. Le Roy, A. Pasquer, C. Eveno, S. Gaujoux, D. Pezet, C. Gronnier, D. Collet, J.H. Lefevre, N. Carrere, G. Poncet, O. Glehen, D. Goeré, G. Piessen, B. Meunier, J.-J. Tuech, C. Brigand, N. Regenet, J.-M. Regimbeau, S. Msika, M. Karoui, M. Pocard, Service de chirurgie générale et digestive [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université-Sorbonne Université, Service de Chirurgie Générale et Digestive [Hôpital de Hautepierre], Hôpital de Hautepierre [Strasbourg], Service de Chirurgie Hépatobiliaire et Digestive [CHU Pontchaillou], CHU Pontchaillou [Rennes], Service Chirurgie Digestive et Hépato-biliaire [CHU Estaing], CHU Estaing [Clermont-Ferrand], Service de Chirurgie Digestive et cancerologique [CHU Saint-Etienne - Hôpital Nord], Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne), Carcinose Angiogenèse et Recherche Translationnelle, Angiogenese et recherche translationnelle (CART U965), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service Chirurgie Digestive, Centre Hospitalier Universitaire de Clermont-Ferrand, Lille Neurosciences & Cognition - U 1172 (LilNCog (ex-JPARC)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Department of Oncologic Surgery, Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Department of Surgical Oncology, Université Paris-Sud - Paris 11 (UP11), Hôpital Claude Huriez [Lille], CHU Lille, Service de chirurgie digestive [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Hôpital Louis Mourier - AP-HP [Colombes], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Department of SurgeryAP-HP, Henri Mondor University Hospital, Service de Chirurgie d'Oncologie Digestive [CHU Lariboisière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Lariboisière-Fernand-Widal [APHP], CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université, Service de chirurgie digestive [Strasbourg-Hautepierre], Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte (M2iSH), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre de Recherche en Nutrition Humaine d'Auvergne (CRNH d'Auvergne)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Hôpital Claude Huriez, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Sorbonne Université (SU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de Chirurgie Digestive et Hépatobiliaire [CHU Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, CHU Clermont-Ferrand, Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon, Lille Neurosciences & Cognition - U 1172 (LilNCog), Centre Jean Perrin [Clermont-Ferrand] (UNICANCER/CJP), UNICANCER, Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer - U837 (JPArc), Université Lille Nord de France (COMUE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre de Recherches en Cancérologie de Toulouse (CRCT), Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Ciblage thérapeutique en Oncologie (EA3738), Université de Lyon-Université de Lyon, Université Paris Cité (UPCité), Hopital Saint-Louis [AP-HP] (AP-HP), Department of Digestive and Oncological Surgery [Lille], CHU Lille-CHU Lille-Université de Lille, Département de chirurgie digestive, CHU Strasbourg, Chirurgie digestive [CHU Amiens], CHU Amiens-Picardie, Simplification des soins chez les patients complexes - UR UPJV 7518 (SSPC), Université de Picardie Jules Verne (UPJV), Centre de recherche sur l'Inflammation (CRI (UMR_S_1149 / ERL_8252 / U1149)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), AP-HP - Hôpital Bichat - Claude Bernard [Paris], CHU Pitié-Salpêtrière [AP-HP], and Hôpital Lariboisière-Fernand-Widal [APHP]

Subjects
medicine.medical_specialty, [SDV]Life Sciences [q-bio], medicine.medical_treatment, Antineoplastic Agents, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, Adenocarcinoma, MESH: stomach neoplasms / surgery, surgical management, Perioperative Care, MESH: lymph node excision / standards, 03 medical and health sciences, 0302 clinical medicine, MESH: adenocarcinoma / surgery, Gastrectomy, Stomach Neoplasms, Laparotomy, medicine, Humans, Lymph node, Neoplasm Staging, MESH: perioperative care / standards, business.industry, Cancer, [SDV.BBM.BM]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology, Cytoreduction Surgical Procedures, General Medicine, medicine.disease, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, Neoadjuvant Therapy, 3. Good health, Surgery, medicine.anatomical_structure, Chemotherapy, Adjuvant, 030220 oncology & carcinogenesis, Conventional PCI, recommendations, Peritoneal Cancer Index, MESH: gastrectomy / standards, Lymph Node Excision, 030211 gastroenterology & hepatology, Dumping syndrome, Lymphadenectomy, gastric adenocarcinoma, business
Abstract

International audience; Gastric adenocarcinoma (GA) is the 5th most common cancer in the world; in France, however, its incidence has been steadily decreasing. Twenty-five experts brought together under the aegis of the French Association of Surgery collaborated in the drafting of a series of recommendations for surgical management of GA. As concerns preoperative evaluation and work-up, echo-endoscopy aimed at clarifying lymph node status should be performed in all candidates for surgical resection and exploratory laparoscopy in cases of GA cT3/T4 and/or N+ for peritoneal carcinomatosis. On the other hand, PET-scan should not be performed systematically, but only when the other modalities for diagnosis prove insufficient. Laparotomy remains the route of choice to achieve total or partial gastrectomy with D2 lymph node lymphadenectomy for advanced lesions (> T2N0). To limit the risk of dumping syndrome and esophageal reflux and as a way of reestablishing continuity, construction of a jejunal pouch on Roux-en-Y following total gastrectomy is recommended. In cases of peritoneal carcinosis in GA with a low peritoneal cancer index (PCI) (

Published
2020
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2. Cytoreductive surgery and HIPEC improve survival compared to palliative chemotherapy for biliary carcinoma with peritoneal metastasis: A multi-institutional cohort from PSOGI and BIG RENAPE groups

Author

I. Amblard, F. Mercier, D.L. Bartlett, S.A. Ahrendt, K.W. Lee, H.J. Zeh, E.A. Levine, D. Baratti, M. Deraco, P. Piso, D.L. Morris, B. Rau, A.A.K. Tentes, J.-J. Tuech, F. Quenet, E. Akaishi, M. Pocard, Y. Yonemura, G. Lorimier, D. Delroeux, L. Villeneuve, O. Glehen, G. Passot, J. Abba, K. Abboud, M. Alyami, C. Arvieux, N. Bakrin, J.-M. Bereder, D. Bouzard, C. Brigand, S. Carrère, F. Dumont, C. Eveno, O. Facy, F. Guyon, R. Kianmanesh, R. Lo Dico, F. Marchal, P. Mariani, P. Meeus, S. Msika, P. Ortega-Deballon, B. Paquette, P. Peyrat, N. Pirro, J. Porcheron, P. Rat, O. Sgarbura, E. Thibaudeau, F. Zinzindohoue, S.H. Baik, A. Bhatt, P. Cachin, W. Ceelen, I. De Hingh, M. De Simone, P. Dubé, R.P. Edwards, J. Franko, L. Gonzalez-Bayon, V. Gushchin, M.P. Holtzman, M.-C. Hsieh, D. Kecmanovic, K. Lehmann, Y. Liu, S. Mehta, S. O'Dwyer, E. Orsevigo, P.K. Pande, E.J. Park, J.F. Pingpank, F. Rajan, A. Sardi, L. Sideris, A. Sommariva, J. Spiliotis, P. Sugarbaker, M. Teo, R. Yarema, R. Younan, S.S. Zaveri, Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Ciblage thérapeutique en Oncologie (EA3738), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon, Service de chirurgie digestive [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Institut de Recherche en Cancérologie de Montpellier (IRCM - U1194 Inserm - UM), CRLCC Val d'Aurelle - Paul Lamarque-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Service de Chirurgie d'Oncologie Digestive [CHU Lariboisière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut de Cancérologie de l'Ouest [Angers/Nantes] (UNICANCER/ICO), UNICANCER, and Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)

Subjects
Adult, Male, medicine.medical_specialty, Peritoneal metastasis, medicine.medical_treatment, [SDV.CAN]Life Sciences [q-bio]/Cancer, 030230 surgery, 03 medical and health sciences, 0302 clinical medicine, Klatskin, medicine, Humans, Prospective Studies, Registries, Peritoneal Neoplasms, Aged, Aged, 80 and over, Chemotherapy, business.industry, Gallbladder, Cytoreduction Surgical Procedures, Hyperthermia, Induced, General Medicine, Middle Aged, Hilar cholangiocarcinoma, Prognosis, Gemcitabine, 3. Good health, Surgery, Biliary carcinoma, Survival Rate, medicine.anatomical_structure, Bile Duct Neoplasms, Oncology, 030220 oncology & carcinogenesis, Cohort, Peritoneal Cancer Index, Intra-hepatic cholangiocarcinoma, Female, Hyperthermic intraperitoneal chemotherapy, France, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Follow-Up Studies, medicine.drug
Abstract

Background Peritoneal metastasis from biliary carcinoma (PMC) is associated with poor prognosis when treated with chemotherapy. Objective To evaluate the impact on survival of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), and compare with conventional palliative chemotherapy for patients with PMC. Material and methods A prospective multicenter international database was retrospectively searched to identify all patients with PMC treated with a potentially curative CRS/HIPEC (CRS/HIPEC group). The overall survival (OS) was compared to patients with PMC treated with palliative chemotherapy (systemic chemotherapy group). Survival was analyzed using Kaplan-Meier method and compared with Log-Rank test. Results Between 1995 and 2015, 34 patients were included in the surgical group, and compared to 21 in the systemic chemotherapy group. In the surgical group, median peritoneal cancer index was 9 (range 3–26), macroscopically complete resection was obtained for 25 patients (73%). There was more gallbladder localization in the surgical group compared to the chemotherapy group (35% vs. 18%, p = 0.001). Median OS was 21.4 and 9.3 months for surgical and chemotherapy group, respectively (p=0.007). Three-year overall survival was 30% and 10% for surgical and chemotherapy group, respectively. Conclusion Treatment with CRS and HIPEC for biliary carcinoma with peritoneal metastasis is feasible and may provide survival benefit when compared to palliative chemotherapy.

Published
2018
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3. Multicentre study of neoadjuvant chemotherapy for stage I and II oesophageal cancer

Author

S Bekkar, C Gronnier, F Renaud, A Duhamel, A Pasquer, J Théreaux, J Gagnière, B Meunier, D Collet, C Mariette, A Dhahri, D Lignier, C Cossé, J-M Regimbeau, G Luc, M Cabau, J Jougon, B Badic, P Lozach, J P Bail, S Cappeliez, I El Nakadi, G Lebreton, A Alves, R Flamein, D Pezet, F Pipitone, B Stan-Iuga, N Contival, E Pappalardo, X Coueffe, S Msika, S Mantziari, N Demartines, F Hec, M Vanderbeken, W Tessier, N Briez, F Fredon, A Gainant, M Mathonnet, J M Bigourdan, S Mezoughi, C Ducerf, J Baulieux, J-Y Mabrut, O Baraket, G Poncet, M Adam, D Vaudoyer, P Jourdan Enfer, L Villeneuve, O Glehen, T Coste, J-M Fabre, F Marchal, R Frisoni, A Ayav, L Brunaud, L Bresler, C Cohen, O Aze, N Venissac, D Pop, J Mouroux, I Donici, M Prudhomme, E Felli, S Lisunfui, M Seman, G Godiris Petit, M Karoui, C Tresallet, F Ménégaux, J-C Vaillant, L Hannoun, B Malgras, D Lantuas, K Pautrat, M Pocard, P Valleur, J H Lefevre, N Chafai, P Balladur, M Lefrançois, Y Parc, F Paye, E Tiret, M Nedelcu, L Laface, T Perniceni, B Gayet, K Turner, A Filipello, J Porcheron, O Tiffet, N Kamlet, R Chemaly, A Klipfel, P Pessaux, C Brigand, S Rohr, N Carrère, C Da Re, F Dumont, D Goéré, D Elias, C Bertrand, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer - U837 (JPArc), Université Lille Nord de France (COMUE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, Service de Chirurgie Hépatobiliaire et Digestive [Rennes] = Hepatobiliary and Digestive Surgery [Rennes], CHU Pontchaillou [Rennes], and Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer - U1172 Inserm - U837 (JPArc)

Subjects
Male, medicine.medical_specialty, Esophageal Neoplasms, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Population, Adenocarcinoma, Disease-Free Survival, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Antineoplastic Combined Chemotherapy Protocols, medicine, Humans, 030212 general & internal medicine, Hospital Mortality, education, Neoadjuvant therapy, Chemotherapy, education.field_of_study, business.industry, Mortality rate, Hazard ratio, Case-control study, Cancer, Middle Aged, medicine.disease, Neoadjuvant Therapy, 3. Good health, Surgery, Europe, Chemotherapy, Adjuvant, 030220 oncology & carcinogenesis, Case-Control Studies, Propensity score matching, Carcinoma, Squamous Cell, Female, Neoplasm Recurrence, Local, business
Abstract

Background The benefit of neoadjuvant chemotherapy (NCT) for early-stage oesophageal cancer is unknown. The aim of this study was to assess whether NCT improves the outcome of patients with stage I or II disease. Methods Data were collected from 30 European centres from 2000 to 2010. Patients who received NCT for stage I or II oesophageal cancer were compared with patients who underwent primary surgery with regard to postoperative morbidity, mortality, and overall and disease-free survival. Propensity score matching was used to adjust for differences in baseline characteristics. Results Of 1173 patients recruited (181 NCT, 992 primary surgery), 651 (55·5 per cent) had clinical stage I disease and 522 (44·5 per cent) had stage II disease. Comparisons of the NCT and primary surgery groups in the matched population (181 patients in each group) revealed in-hospital mortality rates of 4·4 and 5·5 per cent respectively (P = 0·660), R0 resection rates of 91·7 and 86·7 per cent (P = 0·338), 5-year overall survival rates of 47·7 and 38·6 per cent (hazard ratio (HR) 0·68, 95 per cent c.i. 0·49 to 0·93; P = 0·016), and 5-year disease-free survival rates of 44·9 and 36·1 per cent (HR 0·68, 0·50 to 0·93; P = 0·017). Conclusion NCT was associated with better overall and disease-free survival in patients with stage I or II oesophageal cancer, without increasing postoperative morbidity.

Published
2016
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